| NPI | 1518303957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 25952) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1115234) |
| 363L00000X Nurse Practitioner (Licence: KY 3008051) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2019-08-28 |